Changes in deep femoral artery topography during open revascularization of the lower limbs

Abstract

To study topographic changes of femoral triangle arteries during open revascularization of the lower limbs. A retrospective study included 30 men aged 59.6±3 years with atherosclerotic femoropopliteal occlusion and chronic lower limb ischemia IIb-III stage according to the Pokrovsky-Fontaine classification. All patients underwent open reconstructive interventions. Ten patients underwent above-knee femoropopliteal replacement with a synthetic prosthesis, 10 patients - above-knee femoropopliteal bypass with a synthetic prosthesis, 7 patients - above-knee femoropopliteal bypass with autologous vein, 3 patients - below-knee femoropopliteal bypass with autologous vein. Control group consisted of 30 healthy mean aged 60±2 years. Ultrasound was carried out using the Esaote My Lab Alfa scanner (3-12 MHz linear transducer and 3-5 MHz convex transducer). In healthy volunteers, deep femoral artery always arose from common femoral artery under the angle ≤30° in all cases (20° - 93.3% of cases, 30° - 6.7% of cases). In patients with previous surgical treatment, angle of deep femoral artery varied from 35 to 80°. After femoropopliteal bypass grafting with autologous vein, angle of deep femoral artery varied from 35 to 45° (35° - 8 patients, 40° - 1 patient, 45° - 1 patient). After femoropopliteal bypass grafting with a synthetic prosthesis, angle of deep femoral artery increased up to 40-50° (40° - 2 patients, 50° - 8 patients). In case of previous femoropopliteal replacement with a synthetic prosthesis, angle of deep femoral artery increased up to 70-80° (70° - 7 patients, 75° - 2 patients, 80° - 1 patient). Normally, angle of deep femoral artery does not exceed 30°. Open reconstructive surgery on femoropopliteal arteries increases this value from 30° to 80°. Minimal changes are observed after femoropopliteal bypass grafting with autologous vein.